The role of CHADS2 and CHA2 DS2 -VASc scores in the prediction of stroke in individuals without atrial fibrillation: a population-based study.
J Thromb Haemost. 2016 Apr 1;
Authors: Saliba W, Gronich N, Barnett-Griness O, Rennert G
Abstract
BACKGROUND: CHADS2 and CHA2 DS2 -VASc are validated scores used to predict stroke in patients with atrial fibrillation (AF). We aimed to examine the performance of these scores in predicting stroke in individuals without AF.
METHODS: Using the computerized database of the largest HMO in Israel, we identified all not-anticoagulated adults, aged 50 years or older on 1 January 2012. The cohort was followed for the occurrence of stroke or TIA until 31 December 2014.
RESULTS: Of 1,053,871 individuals without AF at baseline; 34,215 developed stroke/TIA during a follow-up of 3,014,002 person-years (stroke/TIA incidence rate, 1.14 per 100 person-years). Incidence rate of stroke/TIA increased in a graded manner with increasing CHADS2 score: 0.36, 0.89, 1.89, 2.96, 4.31, 5.37, and 6.62 per 100 person-years for CHADS2 score of 0 to 6 points, respectively (P < 0.001). Results were similar for CHA2 DS2 -VASc score. A similar graded increasing trend in stroke/TIA incidence rate was observed in a cohort of 46,657 patients with AF at baseline; however, stroke/TIA rates were higher in each score stratum compared to the rates of individuals without AF. The area under the receiver operating characteristic curve was 0.718 (95% CI, 0.715-0.721) and 0.714 (0.711-0.717) for CHADS2 and CHA2 DS2 -VASc scores, respectively in individuals without AF, and 0.606 (0.598-0.614) and 0.610 (0.602-0.618), respectively in individuals with AF.
CONCLUSIONS: CHADS2 and CHA2 DS2 -VASc scores have a relatively high performance for stroke/TIA prediction in individuals without AF which is comparable to their performance in patients with AF. This article is protected by copyright. All rights reserved.
PMID: 27037960 [PubMed - as supplied by publisher]